jun 91 87p. iowa - eric · 2014-05-05 · 6. identifies the special needs of residents/patients...

DOCUMENT RESUME

ED 355 363 CE 063 187

TITLE Hospital Nurse Aide. Revised.INSTITUTION Iowa Univ., Iowa City. Coll. of Education.SPONS AGENCY Iowa State Dept. of Education, Des Moines. Bureau of

Career and Vocational Education.PUB DATE Jun 91CONTRACT FCS-91-03-06NOTE 87p.PUB TYPE Guides Classroom Use Teaching Guides (For

Teacher) (052)

EDRS PRICE MF01/PC04 Plus Postage.DESCRIPTORS *Allied Health Occupations Education; Competency

Based Education; Course Content; Course Descriptions;*Curriculum Development; *Health Services; Hospitals;*Nurses Aides; Postsecondary Education; StatewidePlanning

IDENTIFIERS Iowa

ABSTRACT

This report presents results of a project to revisethe current 120-hour advanced nurse aide course to include allrecommended minimum competencies. A three-page description of projectobjectives, activities, and outcomes is followed by a list of thecompetencies for the 75-hour nurse aide course for long-term care andfor the 120-hour advanced nurse aide course. The revised 130-hourcourse follows. It contains a course description, outline of methodsfor delivering the course, and recommendations for course instructorand evaluation. A list is provided of those competencies that thenurse aide should have following completion of this course, inaddition to those achieved in the 75-hour course. The course containsfour units: introduction to acute care, providing basic nursing carein acute care setting, caring for patients on special units,emergency situations and cardiopulmonary resuscitation. Compol-,nts ofeach unit are unit overview, recommended time requirement,objectives, content outline, and methods of instruction. A resourcelist is provided. Five skills checklists are also attached: admittinga patient, transferring a patient, discharging a patient, isolationtechnique, and assisting patient with deep breathing exercises. Eachchecklist lists necessary equipment and skills to be evaluated.(YLB)

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Reproductions supplied by EDRS are the best that can be madefrom the original document.

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HOSPITAL NURSE AIDE

Project of

Program in Health Occupations EducatiorCollege of Education

The University of Iowa

in cooperation with

Iowa Department of EducationBureau of Technical and Vocational Education

U.S. DEPARTMENT OF EDUCATIONOthcept Educatronai Research and Improvement

EDI7ATIONAL RESOURCES INFORMATIONCENTER (ERIC)

This document has been reproduced asreceived from the person or orgaruzahononchnattngMulor changes have been made to ImprovereproductIon quality

Fonts of vev. or Op.OnS stated on Ihis docu-ment do not necessarily represent officialOEM pos.kon or pokey

Revisions by:Joyce Brandt, Ph.D. EducationState ConsultantIn conjunction withState Committees listed in Acknowledgements

Revised June 1991

Sn.rC

BEST Win AVAiLlai

'PERMISSION TO REPRODUCE TH,SMATERIAL HAS BEEN GRANTEC BYI

1

TO ItHE EDUCATIONAL RESOURCESINFORMATION CENTER (ERIC)

1*

The University of Iowa and the Iowa Department of Education do not discrimi-nate in their educational programs and activities on the basis of race,national origin, color, religion, sex, age, or handicap. The University andthe Department also affirm their commitment to providing equal opportunitiesand equal access to facilities without reference to affectional or associ-ational preference. For additional information on nondiscrimination policies,contact the Coordinator of Title IX and Section 504 in the Iowa Department ofeducation, Grimes State Office Building, Des Moines, IA 50319, phone515/281-8584 or the Coordinator of Title IX and Section 504 in the Office ofAffirmative Action, 202 Jessup Hall, The University of Iowa, Iowa City, IA52242, phone 319/335-0705.

ACKNOWLEDGEMENTS

The third revision of the nurse aide course (act.,:e-hospital) were accomplishedthrough the efforts of two state-wide committees. The first committee was theTechnical Assist Committee (TAC) required by SF449, the second committee wasstate-wide committee of employers and educators who developed the curriculumfrom the competencies identified by the TAC. Both committees were essentialto the process. Thanks and appreciation for those who took the time andrecognized the need for the revisions.

TECHNICAL ASSIST COMMITTEE (TAC)

JoAnn Tapper

Kathie Mahen

Betty Dowd

Marcia Martin

Colleen Bean

Norma Mae

Tammy Spear

Debra Caster

Tony Anthony

Dina Economus

Special Thanks to Margaret Ellibee who facilitated the TAC.

CURRICULUM COMMITTEE

JoAnn Tapper Karen Mueller

Kathi Mahen Norma Jackson

Carol Hartwig Rachelle Burks

Pa Nolan Janelle Nielson

Betty Brend Kate McNally

Jackie Lambert Charlotte Neuman

A special thanks to V. Jane Muhl who provided technical assist for secondary.

:13\ PLC

Activity Numbet: FCS-91-03-06

Activity Title: Advanced"Nurse Aide Curriculum Project

B. Final Report

1. Objectives

1. Use the competencies identified by the TAC committee to review the

current 120 hr. advanced nurse aide course and make recommenda-tions for revisions that will include all of the recommended mini-

mum competencies.2. With the assistance of a statewide committee determine if there

are additional competencies that need to be included in the 120

hour course for approval.3. Revise the current advanced nurse aide course to include all of

the competencies identified by the state advisory committee.

4. Once course is completed conduct a state meeting to disseminatecurriculum and provide teacher training for delivery of the curri-

cula.

2. Procedures

1. Organize a state advisory committee comprised of employers, asso-ciation members, educators and state agencies who will educate andhire the completers of the advanced (hospital) nurse aide course.

2. Provide the state advisory committee with the competencies devel-oped by the TAC committee and through several telenet committeemeetings assess/refine competencies to develop course for hospital

nurse aides.3. Using the competencies required in the 75 HR. nurse aide course

for long term care nursing facilities identify additional compe-tencies required for hospital nurse aide.

4. Revise the current course to include the additional competenciesrequired for hospital nurse aide. (The 75 HR. nurse aide course

for long term care would be the core for this course - additional

hours would be added to prepare the aide for hospital employment).

5. Conduct a state meeting to disseminate the materials to teach the

additional competencies. Include these materials in the current

teacher training program for nurse aide instructors.

3. Audience Served

The majority of the nurse aides in Iowa are female, and at this time

all of the nurse aide teachers (required experience in long term care)

are female. Some minorities, special needs students, and limitedEnglish speaking participate in the nurse aide classes.

4. Special Activities

Telenet meetings of the state advisory committee, and a state meeting

to review/critique and disseminate the materials were the primary

Activity Number: FCS-91-03-06

.1

Activity Title: Advanced Nurse Aide Curriculum Project

activities required for this project in addition to the actual revi-sion of the curriculum.

5. Educational Equity

All of the area colleges and high schools who teach this course pro-vide equal access to the program. The competency test can be read forthose persons who have reading disabilities, special testing proce-dures are also used for limited English speaking populations. Thecurriculum is written on the 6th grade level as much as possible, how-ever, some medical terms must be used so the completer can effectivelycommunicate with others providing care.

6. Evaluation Methods

Throughout the time the writer was making the course revisions, theadvisory committee assessed the project either as a group or individu-ally. Prior to final publication the advisory committee reviewed andapproved the revisions.

In addition, the instructors of the course will submit summary evalua-tions from students and provide the Program in Health Occupations withthese summaries as well as their own evaluation. These evaluationswill be kept on file and used to update the course in the future.

7. Evaluation Findings

The course has been revised. (Attached copies) The state advisorycommittee feels the course will meet the educational needs of thenurse aide in the hospital. The course will be submitted to the IowaHospital Association, Nurse Administrators for final approval at theirfall meeting. Minutes of the meeting will be added to this report.

8. Benefits/Impact of Project

Since the core 75 Hr. course has been revised the hospitals and healthcoordinators have requested this course be revised. With the revi-sions there:1. will now be consistency in preparing these aides and the aides can

more effectively work in all hospitals or long term care facili-ties

2. will be improved care provided by nurse aides, because they can nowuse the competencies acquired in the course to provide safe care,

3. will help in decreasing some of the cost of health care - sincethe course completers will need less orientation and can provideservices sooner after hire.

0

Activity Number: FCS-91-03-06

Activity Title: Advanced Nurse Aide Curriculum Project

9. Recommendations

The course evaluations by students and instructors should be kept on

file for course revisions in three-four years or as the industry

changes and requires an update.

COMPETENCIES FOR 75-120 HOUR NURSE AIDE COURSE

Communicate effectively with residents/patients, health facility staff andresident/patient family/visitors

*1. Uses correct medical terminology and abbreviations.*2. Use effectively the telephone and intercom.*3. Record and report pertinent observations related to resident/patient

procedures and conditions.*4. Reports and records procedures accurately.*5. Records/reports intake and output.*6. Listens effectively.*7. Participates in a discussion.*8. Follows directions.

Interacts appropriately with resident/patients, health facility staff andresident/patient family/visitors.

1. Uses the philosophy of restorative/rehabilitation when providingcare

*2. Identifies basic emotional needs.*3. Identifies basic changes in normal growth and development and apply in

care situation.4. Identifies the physical/social/emotional changes that occur in

elderly and chronically ill.5. Differentiates between the care needs of the acutely and chronically

ill.

6. Identifies the special needs of residents/patients with disabilities,including physical problems, mental illness, mental retardation,and dementias.

*7. Encourages resident/patients to be as independent as possible.

Uses ethical/legal principles in providing care and fulfilling job responsi-bilities

1. Describes various types of care facilities.2. Differentiates between various types of health care facilities and

their administrative structure.3. Identifies the relationship between various governmental and private

agencies that provide guidelines for resident/patient care.4. Identifies roles of various health care personnel within facilities

especially the role of the nurse aide.*5. Demonstrates responsibility concerning resident/patient rights.*6. Practices confidentiality.*7. Applies ethical practices.*8. Follows institutional policies.

8

L.

?ractices safety measures in providing resident/patient care.*1. Uses correct hand washing techniques.*2. Follows propar .infectIon control techniques.3. Uses CDC guidelines (universal precautions) in providinz :are.

*4. Maintains a safe, clean environment.*5. Uses correct body mechanics.*6. Follows emergency procedures for fire and other disasters.7. Provides emergency care for cht.:jng resident/patient.

*8. Positions patient/resident's call light within reach.*9. Uses correct procedures for safely restraining resident :_bent.

Uses information on care plan to assist the resident with persona: hygiene.*1. Bathes resident/patient or assist with bathing.2. Assists resident/patient with tub bath/shower.

*3. Performs perineal care.*4. Performs or assist with oral hygiene including mouth an denture

care.

*5. Performs a patient/resident back rub.*6. Applies care for a patient/residents nails.*7. Assists with or shave patient/resident.*8. Assists resident/patient with dressing/undressing.*9. Assists resident/patient with hair care.

*10. Assists resident/patient with adaptive devices, includLnz sensorydevices.

*11. Assists resident/patient with nutritional needs.*12. Makes occupied bed.*13. Makes unoccupied bed.

Perform special procedures for the resident/patient.*1. Provides for resident/patient privacy.*2. Positions patient/resident in correct body alignment.*3. Transports patient/resident, using correct equipment.*4. Assists patient/resident in standing and ambulating.*5. Observes and maintainr; urinary drainage system.6. Assists resident/patient with bladder/bowel training.

*7. Assists resident/patient with elimination needs.*8. Measures and records temperature, pulse, respiration en:: .7..lood

pressure.*9. Uses techniques that help prevent pressure sores.

*10. Performs passive range of motion.*11. Directs active range of motion.*12. Measures and records patient/resident height and wei7.:nt.

*13. Assists with local applications of heat and cold.

*14. Collects urine, feces and sputum specimen as directed.

*15. Prepares and administers an enema.*16 Identifies the five steps of approaching death or reacti:ns to

approaching death.*17 Explains the procedure for post mortem care.

*18 identifies ways to ease the impact of loses.

19 Performs noninvasive diabetic urine testing.

*20 Assists licensed nurse with admitting procedures.

*21 Assists licensed nurse with discharge procedure.

*22 Records personal property inventory.

*23 Assists licensed nurse with patient transfer procedures.

24 Assists licensed nurse with pre and post operative care.

25. Provides care for acutely ill patients.26. Provides care for children and new mothers.

*27. Applies anti-embolism elastic stockings.

*28. Completes certification in Basic Cardiac Life Support - Module C.

*Competencies are those that were validated by the TAC for Nurse Aide.

Bold type competencies are those that are not included in the approved

75 hour course.

L .

HOSPITAL NURSE AIDE

Course Description: This 130 hour course is des-7.gned as an optional addi-tional unit of instruction to be given either in conjunction with or followingthe approved 75 hour course. The 75 hour course meets the OBRA (Nursing HomeReform) requirements for nurse aides who work in long term care. This addi-tional material provides the learner with the content emphasizing the knowl-edge, attitude and skills necessary for providing patient care in the acutesetting.

Pre-Requisite: Successful completion of the 75 hour Long Term Care AideCourse.

Methods for Delivering the Course: The Hospital Nurse Aide Course requires anadditional 25 hours of classroom and laboratory and an additional 30 hours ofclinical. The clinical should be in an acute care setting. Following arethree optional methods for offering the classroom and clinical.

1. Community colleges offer the total 55 hours and provide collegesupervised clinical experience.

2. .High school programs offer the course with additional support class,laboratory and clinical experiences to meet the requirements of SF449.The Health Occupations Education Program Guides for Secondary providesuggestions for the additional content.

3. Community colleges and hospitals develop a formal agreement whereby thecommunity colleges teach the 25 hour class and laboratory portion andthe hospitals assume responsibility for the 30 hour clinical portion.Hospital committee members felt the clinical could become part of thebasic orientation provided for nurse aides.

Course Instructor: The course instructor should be a registered nurse.

Course Evaluation: Successful completion of the Hospital Nurse Aide Courseincludes a minimal passing score on written quizzes, skills checklist, andstate final examination. A certificate of successful completion will beawarded.

.1

HOSPITAL NURSE AIDE

Competencies Included in the Additional Units

Upon successful completion of the acute care units the nurse aide should havethe following competencies in addition to those achieved in the 75 hcurcourse.

Differentiates between the procedures for providing care in acute care andlong term care.*Compares the organization of acute care with long term care.*Describes how the care needs of the acutely ill differ from those of

the chronically ill*Compare the health professionals role in acute care setting with

their role in long term care.*Identifies legal responsibilities of the nurse aide in acute care,

including living wills and durable power of attorney.Communicates effectively with the patient in acute care, effec-tively uses the telephone and intercom.Obtain appropriate patient information from nursing supervisor.

practices safety measures in providing patient care in acute care setting.*Investigate the human growth and development need of infants, chil-

dren and adults.*Explain the nurse aides role in using the nursing care plan in

acute care.*Uses CDC guidelines (universal precautions) in providing care to

patient in isolation.*Assists patients in acute care to follow dietary orders.Assists licensed nurse with admission procedures.Assists licensed nurse with discharge procedure.Assists licensed nurse with patient transfer procedures.Assists licensed nurse with pre and post operative care.Provides care for acutely ill patients.Provides care for children and new mothers.Applies anti-embolism elastic stockings.

Completes certification in Basic Cardiac Life Support - Module C.*Competencies not identified by TAC.

r)14

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HOSPIT.TRSE AIDE

Unit I:

Introduction to Acute Care

Overview:

During the study of this unit the nurse aide investigates the difference between long term care and acute

care; including reasons patients are receiving care, services provided, personnel providing services and

how the acute care system functions.

Recommended 2-3 hours

OBJECTIVE

CONTENT

METHOD

1.0 Compare the hospital (acute)

I. Acute care facilities (hospitals)

care facility with long term

A. Definition of acute care

care facility.

B. Types of hospitals

1. General

a. Primary care

b. Secondary care

c. Tertiary care

2. Specialty

1.1 List the purposes of acute care

C. Purposes

hospitals.

I. Provide care/treatment for ill

2. Prevent diseases

3. Promote health

4. Education

5. Research

D. Organization of hospitals

1. Administration

2. Departments within hospitals

a. Nursing

b. Medical

c. Dietary

d. Housekeeping

e. Radiography (x-ray)

f. Laboratory

g. Emergency services

h. Chaplain services

i. Central supply

j. Medical record department

k. Admissions

1. Intensive and/or coronary care

3. Service areas in hospitals

a. Surgical

b. Operating rooms

c. Medical units

d. Mental health

r-I

Lecture/discussion

Tour of hospital 4

HOSPITAL NURSE AIDE

Unit I.


Page 2

Overview:




OBJECTIVE

CONTENT

METHOD

e. Pediatrics

f. Obstetrics

g. Outpatient

h.

Rehabilitation unit

1.2 Discuss different methods of

D. Nursing care organization in acute care

organizing nursing care in acute

hospital

Lecture/discussion

care hospital.

1. Direct assignment.

Nurse manager makes

all assignments

2. Team nursing - case management

a. Nurse manager - resource person

b. Staff divided into teams

c. A licensed nurse leader of each team

d. Groups of patients assigned each team

e. Tasks assigned each member

3. Primary nursing - total patient care

a. Professional nurse full responsibility

for all patients

b. Nurse aides provide support for licensed

nurse

1.3 Identify new skills you will need

ENew skills

to work as a nurse aide in acute

1. Care of acutely ill

care.

2. Care of patients in specialty areas

a. Pre and post operative areas

b. Pediatrics

c. Obstetrics

3. Nursing tasks

a. Admission/transfer/discharge

b. Caring for patients in isolation

c. Caring for patients receiving special nutrients

d. Making different types of observations

e. Using different methods of identifying

patients

51) Hospital number

2) Room/bed number

3) Wrist band

1111

I_ 0

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HOSPIT.RSE AIDE

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Unit I:


Page 3

Overview:




OBJECTIVE

CONTENT

METHOD

4. Physical organization of nursing service units

5. Providing emergency care for patients (BCLS)

1.4 Communicate effectively in

II. Communications

Lecture/discussion

acute care setting.

A. Nursing care plan - nursing care conferences

1. Goals of nursing care

2. Nurse aide's role in providing the care

3. Getting info. from shift reports

a. Aide's participation

1) Aide to aide

2) Supervisor to aide

b. Information aides should collect

B. Physician's orders - how to use

C. Patient chart and contents

D. Assignment sheets

E. Intercom and telephone systems

F. Relationship with others in institution

1.5 Discuss ethical/legal role of

III. Ethical/legal responsibilities in acute care

Lecture/discussion

nurse aide in acute care.

A. Patient rights and responsibilities

B. Aide's role in living wills - durable power

of attorney

C. Patient safety

D. Observations/reports to nurse manager

HOSPITAL NURSE AIDE

Unit 2:

Providing Basic Nursing Care in Acute Care Setting

Overview: This unit provides the additional (above what is in approved 75 hour course) knowledge and skills the nurse

aide needs to function in acute care setting; including admission, transfer, discharge, isolation techniques

and dietary adaptations.

Approx. teaching time 10-12 hours

Includes laboratory

OBJECTIVE

CONTENT

METHOD

2.0 Provide safe nursing care in acute

care setting.

2.1 Explain correct procedure for

I. Admitting/transferring/discharging

Lecture/discussion

admitting a patient.

A. Admitting

1. Assemble equipment

Skills checklist # 1

a. Admission checklist

b. Specimen for urine collection

c. Hospital gown and robe

d. Clothing list

e. Valuables envelope

f. Scale for weight

g. Admission packet

h. Bedpan, basin, emesis basin, etc.

i. Thermometer

j. Other items required per speciality

area

2. Wash hands

3. Fanfold bed linens down

4. Place hospital gown at foot of bed

5. Place supplies in bedside stand (bedpan,

basin, etc.)

6. When.patient arrives introduce self/explain

what you will be doing

7. Escort patient to room - introduce to roommates

8. Provide privacy during admission procedure

9. Ask/assist patient to change into pajamas

10. Weigh and measure patient - record

11. Assist the patient to get into bed

12. Complete the admission checklist

13. Make patient comfortable

14. Assist the patient to put toilet articles in

bedside table

15. If allowed to have fluids get drinking water

4111

HospripuRsE AIDE

4111

Unit 2:

Providing Basic Nu;.sing Care in Acute Care Setting

Page 2




OBJECTIVE

CONTENT

METHOD

2.2 List six rules to follow in

taking care of a patient's

valuables.

2.3 Correctly tranfer a patient.

2.3.1

List three reasons why a

patient may transfer from one

area to another. 21

16. Orient patient to surroundings

17. Explain hospital policy and procedures -

include meal time, etc.

18. Check patient identification

19. Adjust bed according to physician orders

20. Take your completed checklist to your

nurse manager or team leader.

Report

your observations

B. Rules to follow:

taking care of patient's

Lecture/discussion

valuables

1. Itemize the valuables on the admission

checklist

2. Ask the patient to place his/her valuables

in the envelope

3. Close the envelope while you are with the

patient.

Make sure he/she sees you do this

4. Have the patient or relative sign the

itemized list

5. Give the envelope to your nurse manager or

team leader for proper care

a. The security officer picks it up and

takes it to the hospital safe

b. A relative takes it home

c. Admission clerk comes to the

floor and

takes valuables to the safe.

The

patient gets a receipt

6. Being careful in describing these valuables

on the itemized list is very important.

Never touch the patient's money.

Let the

patient count it.

Then you record the

amount.

C. Reason a patient may transfer

1. Request for private room

2. Request transfer from a private room to a

semi-private room

Example of hospital's valuables

list (varies from facility to

facility) show various types

'2 4..

HOSPITAL NURSE AIDE

Unit 2:


Page 3

Overview: This unit provides the additional (above what is in -pproved 75 hour course) knowledge and skills the nurse



OBJECTIVE

CONTENT

METHOD

2.3.2 Describe correct procedure

for transferring a patient.

2.4 Explain correct procedure for

discharging a patient.

3. Move to another unit because of a change

in medical condition

4. Infection control concerns

D. Transferring a patient

1. Assemble your equipment

2. Wash hands

3. Identify the patient by checking the

identification bracelet

4. Ask visitors to Leave room

5. Tell the patient you are going to transfer

him/her to his/her new room

6. Check to be sure the new unit is ready to

recei''e the patient

i. Collect the patient's personal belongings

and equipment that is to be moved with

him/her

8. Transport the patient to his/her new unit

a. The patient can be moved in his/her own

bed from one room to another

b. You may have to transport the patient

by stretcher or wheelchair to his/her

new room

9. Follow all safety precautions when wheeling

the patient to his/her new room

10. Introduce the patient to his/her new room-

mate If there is one

11. Make the patient comfortable in his/her

new room

12. Arrange the unit

13. Report to the nurse manager or team leader

E. Discharging policy - elements

1. Physiological

2. Psychological

3. Socio-cultural

4. Spiritual

Demonstration/return

demonstration

Skills checklist # 2

1111

HOSPIllippURSE AIDE

1111

Unit 2:


Page 4




OBJECTIVE

CONTENT

METHOD

F. Discharging the patient

1. Assemble your equipment

a. Wheelchair

b. Discharge slip

c. Cart

2. Wash your hands

.

3. Identify the patient by checking his/her

identification bracelet

4. Collect all the patient's personal posses-

sions for him/her.

Help him/her to pack

everything that belongs to them

5. Be sure all valuables and medications are

returned to him/her

6. Help the patient get dressed, if

necessary

7. Make sure the patient has his/her written

instructions from the nurse manager

such as:

a. Doctor's orders to follow at home

b. Prescriptions

c. Follow-up schedule of appointments wit.0

the doctor or the clinic

8. Bring the wheelchair to the patient's

bedside.

Help the patient get into it.

9. Before wheeling the patient off the

floor, get the discharge slip from the

nurse manager or ward clerk.

10. Take the patient in the wheelchair to the

discharge desk or cashier or business

office.

11. Wheel the patient to the front door.

Help

him/her out of the wheelchair and into

his/her car or bus.

12. Take the wheelchair and the release form

back to your floor.

Demonstration

Skills Checklist # 3

Example of hospital's discharge

procedure

HOSPITAL NURSE AIDE

Unit 2:


Page 5




OBJECTIVE

CONTENT

METHOD

13. Report to your nurse manager or team leader

that the patient has been discharged.

Report the time of discharge, the type of

transportation used and who it was that

accompanied the patient.

Also report

your observations of anything unusual.

14. Wipe the entire wheelchair with an

antiseptic solution.

15. Strip the linen from the bed.

Put it in

the dirt linen hamper.

16. Wash your hands.

G. Discharge checklist

1. Diet

2. Home care

3. Patient/demonstration of treatments

4. Medications

5. Home health care

2.5 Safely use isolation

II. Isolation Precautions

techniques when required.

A. Purposes of isolation as a means of infection

2.5.1 List purposes of isolation,

control

1. Minimize the spread of infection

2. Protect self and others

3. Protect patient from others

2.5.2 Discuss the basic types

B. Basic types of isolation

of isolation.

1. Strict Isolation

a. Protects persons outside

he isolation

unit from contact with pathogens

1) Staff

2) Other patients

3) Visitors

b. Contamination is prevented from spreading

from the room

c. Common illness requiring strict

isolation

4 I

1111

4111

J41

10

410

HOSPI1111FURSE AIDE

4111

Unit 2:


Page 6




OBJECTIVE

CONTENT

METHOD

2.5.3 List specifications of

strict isolation.

2.5.4 List specifications of

respiratory isolation

1) Chicken Pox

2) Diptheria

3) Small Pox

d. Specifications for Strict Isolation

1) MASKS are indicated for ALL persons

entering the room

2) GOWNS are indicated for all persons

entering the room

3) GLOVES are indicated for all persons

entering the room

4) HANDS MUST BE WASHED AFTER TOUCHING

Film Infection Control

THE PATIENT OR POTENTIALLY CONTAMI-

Control -

NATED ARTICLES AND BEFORE TAKING CARE

Protective Isolation

OF ANOTHER

.5) Private room is indicated

6) ARTICLES CONTAMINATED with infective

material should be discarded or bagged

and labelled before being sent for de-

contamination and reprocessing

3.

Respiratory Isolation

a. Prevents spread of microorganism thorough

air

b. Common illness requiring respiratory

isolation

1) Measles

2) Mumps

3) Whooping Cough

c. Specifications for respiratory isolation

1) MASKS are indicated for those who come

close to the patient

2) GOWNS are indicated if soiling the uniform

is likely

3) GLOVES are indicated for touching in-

fective material

4) HANDS MUST BE WASHED AFTER TOUCHING THE

HOSPITAL NURSE AIDE

Unit 2:


Page 7


aide needs to function in acute care setting; including admission, transfer, discharge, iso]ation techniques


OBJECTIVE

CONTENT

METHOD

2.5.5 List the specifications for

tuberculosis isdation

2.5.6 List the precautions for

enteric isolation

2.5.7 List the precautions for

drainage/secretion precautions

01

PATIENT OR POTENTIALLY CONTAMINATED ARTI-

CLES AND BEFORE TAKING CARE OF ANOTHER

PATIENT

Examples of signs used

5) ARTICLES contaminated with infective

used on isolation

material should be discarded or bagged

doors

or bagged before being sent for decon-

tamination and reprocessing

4. Tuberculosis Isolation (AFB)

5. Enteric Isolation

a. Prevents infections that are transmitted

by direct or indirect contact with fecal

materials

b. Oral ingestion of the pathogens usually

occurs from contaminated hands

c. Specifications for enteric precautions

1) MASKS NOT indicated

2) GOWNS indicated if soiling likely

3) GLOVES are indicated for touching in-

fective material

4) HANDS MUST BE WASHED AFTER TOUCHING THE

PATIENT OR POTENTIALLY CONTAMINATED ARTICLES

BEFORE TAKING CARE OF ANOTHER PATIENT

necessary for articles contaminated

with urine and feces.

Articles must

be disinfected or discarded.

6. Drainage/secretion precautions

a. Prevents spread of pathogens found in

Enteric Precautions

infective purulent materials, drainage

or secretions

b. Pathogens are spread by direct contact

with wound

c. Infection also spread by objects in con-

Film:

Wound, Skin and

32

HOSPIllipURSE

AIDE

Unit 2:


Page 8




OBJECTIVE

CONTENT

METHOD

2.5.8 List the precautions

for blood and body fluids

in contact with wound drainage

d. Common conditions requiring drainage/

secretion precautions

1) Burn infection

2) Conjuntivitis

3) Skin infection

4) Wound infection

e. Specifications for drainage/secretion

isolation

1) MASKS NOT indicated

2) GOWNS indicated if soiling of uniform

likely

3) GLOVES are indicated if touching

Concept Media: Infection

affected material likely

Control, Respiratory and

.4) HANDS ARE WASHED BEFORE TOUCHING

Strict Isolation

ANOTHER PATIENT OR POTENTIALLY CON-

TAMINATED ARTICLES

7. Blood/body fluid precautions

a. Prevents infections being spread by direct

contact with infective blood or body fluids

b. Patients requiring these precautions

1) AIDS

2) Hepatities B, Non - A, Non -B

3) Syphilis

c. Specifications for blood/body fluid

Precautions

1) MASKS NOT required

2) GOWNS indicated if soiling possible

Lecture/discussion

3) GLOVES are worn when touching blood

or body fluids

4) Hands washed immediately if contaminated with

blood or body fluids and before caring for

another patient

5) Articles contaminated with blood or body

fluids should be discarded or bagged and

HOSPITAL NURSE AIDE

Unit 2:


Page 9




OBJECTIVE

CONTENT

METHOD

labelled before sent for decon-

tamination and processing

6) Care should be taken to avoid needle

stick injuries

7) Blood spills should b

cleaned up

promptly with solution of 5.25% sodium

hypochlorite diluted with 1:10 with

2.5.9 Briefly discuss pro-

8. Protective Isolation

tective isolation

a. Prevents infectious organism from

entering isolation unit

b. Protects patient from secondary infection

c. Common illness requiring protective

precautions

1) Leukemia

.2) Extensive noninfected burns for

certain patients

d. Precautions include

1) Hands are washed on entering and

and leaving room

2) GOWNS worn by all entering the room

3) MASKS wcrn by all entering the room

4) Gloves are worn by those having dir-

ect contact with patient

C. Methods for using masks/gowns/gloves

1. Face Masks

2.5.10 Identify when face masks

a. Wear when patient's communicable

Examples of face masks

should be worn for

can be spread by respiratory tract

isolation techniques.

b. All personnel must wear

2. Before applying a face mask, wash your

hands

3. Face masks are effective against spreading

disease

a. For 20-30 minutes only

b. If they are not wet

c. If they are used only once, then

S4.);-)

4111

o

HOSPIT41IpURSE AIDE

1111

Unit 2:


Page 10




OBJECTIVE

CONTENT

METHOD

discarded

2.5.11 Describe the procedure for

4. Techniques for wearing mask

putting on and removing a

a. Assemble your equipment, disposable

mask.

paper mask

b. Wash your hands

c. Remove a clean mask from its container

d. Hold the mask firmly, avoiding unnecessary

handling.

Do not touch the part of the

mask that will cover your face.

Hold the

mask by the strings only.

e. Place the mask over your nose and mouth.

Tie the top strings over your ears first.

Then tie the lower strings.

f. Be sure the mask covers your nose and

mouth during your task or procedure with

patient.

g. When you are ready to take off the mask,

wash your hands.

h. Untie the bottom ties first to avoid

contamination.

Hold the mask by the

strings or loops only.

i. Untie the top strings.

Remove the mask

from your face.

Discard it in the paper

container inside the patient's room.

j. Wash your hands.

2.5.12 Identify reasons for wearing

D. Isolation gowns

isolation gowns.

1. You will usually wear an isolation gown

when caring for a patient in isolation.

2. The gown will protect your clothing from

being contaminated.

3. There are three types of isolation gowns.

a. Cotton twill - reusable after washing.

b. Paper disposable gown.

c. Plastic disposable gown.

4. To be effective, the isolation gown must

Lecture/Discussion

Demonstration


Equipment needed:

Masks

Examples of isolation

gowns

HOSPITAL NURSE AIDE

Unit 2:


Page 11

Overview: This unit provides the additional (above what is in approved 75 hour course) knowledge and skills thenurse



OBJECTIVE

CONTENT

METHOD

cover your uniform completely.

5. Put a clean gown on before entering

isolation room.

6. Remove dirty gown before leaving

isolation room.

7. A special technique is used in putting

gown on, and in removing the gown.

This

must be followed specifically to protect

yourself and other patients.

2.5.13 Demonstrate procedure for

E. Procedure for applying

Skills checklist

putting on isolation gown.

1. With clean hands, roll long sleeves of

Demonstrate/return

uniform above the elbows

demonstration

2. Unfold the gown so that opening is at the

back

3. Put your arms in the sleeves

4. Fit the gown at the neck, making sure the

uniform is covered

5. Reach behind and tie the neck band with a

simple shoelace bow

6. Grasp edges of gown and pull to back

7. Overlap edge of gown, roll gown edges

together in back

2.5.14 Describe the procedure

F. Procedure for removing

Skills checklist

for removing an isolation

1. Untie waist tapes and loosen the gown

gown.

2. Use a paper towel to turn on the faucet

Don't touch the faucet with your fingers

3. Throw paper towel into the wastepaper

basket

4. Wash your hands and dry them with a paper

towel

5. Again, with a dry paper towel, turn off

the faucet

6. Open the neck band of the gown

:17. Place your fingers under one cuff to pull

4111

HOSPI411rURSE AIDE

1111

Unit 2:


Page 12




OBJECTIVE

CONTENT

METHOD

2.5.15 Demonstrate procedure for

donning and removing non

sterile gloves

the sleeve over your hand

8. Pull your arm out of the sleeve by

grasping the opposite sleeve with your

gown covered hand

9. Roll the gown in half with the contaminated

part inside

10. If the gown is washable, put it in the

dirty linen hamper inside the patient's

room.

If the gown is disposable, place it

in the trash container inside the patient's

room.

11. Wash your hands.

12. Use a paper towel to open the door to leave

the room.

Put the towel in the wastepaper

basket inside the patient's room as you

leave.

G. Donning and removing non sterile gloves

1. When to wear

a. In isolation when required

b. Whenever dealing with body secretions

2. Procedure for donning

a. General principles

1) Powdered gloves go on easier

2) Gloves only need to be sterile for

designated sterile procedures

b. Procedure for donning

1. Grasp right glove by left cuff

area - touching inside of glove

2. Keep fingers straight while pulling

glove on

3. Pull on left glove by grasping edge

with right gloved hand

42

HOSPITAL NURSE AIDE

Unit 2:


Page 13




OBJECTIVE

CONTENT

METHOD

2.5.16 Discuss the reasons and

the procedure of bagging

equipment and articles

2.5.17 Discuss the personal care

of the patient in isolation.

c. Procedure for removing contaminated

gloves

1. Gloves will be removed before gown

if wearing one

2. Principle - donot touch contaminated

part of glove with hands

3. Remove right glove by using left

hand pull cuff to remove glove

4. Dispose of glove in designated con-

tainer

5. Place fingers of right hand under

cuff of left glove

6. Pull glove down over and off hand

7. Dispose of glove in designated area

H. Bagging Technique

1. Select the appropriate bag

some

biodegradable etc.

2. Bags differ

regarding designated use

from the isolation unit.

3. One person fully dressed in isolation

garments is in the room.

All materials

to be removed are placed in bags in the

isolation room.

AnIther person outside

the room holds another bag and has it

opened enough that the contaminated gowned

person can drop the contaminated bag into

the clean bag without touching the outside

or the person holding the clean bag.

3. Clean bag is then sealed and marked.

4. Bagging for disposal done in many types

of isolation situations.

I. Personal care of patient in isolation

1. The patient in isolation needs all of

the personal care a regular patient

requires

S44

Demonstration

Skills checklist

Role play

Lecture/discussion

4110

HOSPIllippURSEAIDE

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Unit 2:


Page 14




OBJECTIVE

CONTENT

METHOD

a. Baths

b. Oral hygiene

c. Emotional support

d. Mental stimulation

e. Companionship

f. Nutrition and fluids

2. Sometimes staff does not like taking care

of people in isolation.

The isolated person

can tell this and feels bad concerning his/

her illness.

Always remember to show

consideration for the patient.

If you have

any fears regarding the isolation unit,

discuss these with your immediate supervisor.

3. Older people and children usually find

isolation an upsetting circumstance.

They

enjoy eating and talking with others and

need extra attention if they are placed in

isolation.

2.6 Encourage the patient to

III

Special diets

follow diet requirements.

A. Purpose

Lecture/discussion

1. When a patient can not swallow normally,

liquid feedings are instilled into the

stomach by a NG (nasal-gastric) tube

2.6.1 Recognize the basic parts

B. Nutrients

Lecture/discussion

of food necessary for health.

1. Chemical substances from food

2. Carbohydrates

a. Provide energy

b. Grains, potatoes, sugars, milk

3. Proteins

a. Build and renew body tissues

b. Eggs, milk, meat

4. Fats

a. Energy, maintain tissues

"..ta

b. Oil, butter, meat

4-0

HOSPITAL NURSE AIDE

Unit 2:


Page 15




OBJECTIVE

CONTFNT

METHOD

b. Final post-op

c. Cholesterol

5. Minerals

a. Calcium - milk products - build bones,

teeth

b. Iron - helps body carry oxygen.

Meat

(liver), spinach

c. Potassium - electrolyte maintains

fluid balance -

tomatoes, oranges,

bananas

6. Vitamins

a. Fat soluble - stored in body.

ADEK

b. Water soluble - B's

7. Water - regulates processes

8. Calories

a. Measurement - purpose

b. Requirements

c. Modifications in diet

2.6.2 Review the basic four and

C. Basic four

recognize patient needs.

1. Meat and fish

2. Fruits and vegetables

3. Breads, cereal

4. Dairy products

2.6.3 Describe the various types

D. Types of special diets and reasons patients

of diets and list common

receive them

purposes.

1. Normal or regular

2. Clear liquid

a. Immediate post-op

b. Severely ill

c. Nauseated

3. Full liquid

a. Unable to chew

b. Progressive after surgery

4. Light or soft diet

b. Patient has trouble chewing and/or

48

4111

HOSPITIOURSE AIDE

4111

Unit 2:

Providing Basic Nursing Care in Acute Care

Setting

Page 16

Overview: This unit provides the additional

(above what is in approved 75 hour

course) knowledge and skills the nurse

aide needs to function in acute care setting;

including admission, transfer,

discharge, isolation techniques


OBJECTIVE

CONTENT

METHOD

swallowing

5. Bland

a. Avoid irritation ofG.I. system, e.g.

chili

6. Low residue

a. Omits foods

difficult to digest

7. High calorie

a. Malnourished,

underdeveloped

b. Usually high in protein,

minerals and

vitamins

8. Low calorie

9. High protein

10. Low fat

11. Low cholesterol

12. Low salt

low sodium

13. Supplements

2.6.3 Recognize the situations

E. Appetites

Lecture/discussion

that can affect the

1. Pain

patient's appetite.

2. Activity decrease

3. Emotional

4. Nausea

5. Smells

6. Cultural influences

2.6.4 Review methods for assisting

F. Procedure for setting up

patient's tray

Role play

patient to eat.

1. Passing trays

2. Check diet

3. Assist as needed

G. Review procedure for

feeding a patient

H. Report/recording of patient

dietary intake

2.6.5 Explain the purpose for

I. Intravenous therapy

Lecture/discussion

giving intravenous fluids.

1. Purpose -

to give fluids and

nourishment

Demonstration

to the body

2.6.6 List and explain five rules

2. Rules to follow

to follow when IV's are running.

a. If the needle

has been inserted in the

tenderness at the site (place)

where

HOSPITAL NURSE AIDE

Unit 2:


Page 17

Overview: This unit provides the additional (above what is in approved 75 hour course) knowledge and skills thenurse



OBJECTIVE

CONTENT

METHOD

J1

she may move

b. Make sure patient is never lying on top

of tubing

c. To remove a patient's gown - with

straight I.U.

1) Untie the gown

2) Remove the arm without the IV from

the sleeve

3) Carefully remove the gown from the

arm with the IV, considering the

tube and the container as part of the

arm.

Move the sleeve down the arm,

over the tubing and up to the bottle.

d. To.put clean gown on, reverse procedure.

e. Watch for the following:

1) When you can't see drops of solution

passing from the bottle into the

tubing but there is still some

solution in the bottle.

2) When the plastic drip chamber is

completely filled with the solution.

3) When you see blood in the tubing at

the needle end.

4) When all the solution has run out of

the bottle or the bottle is almost

empty.

5) When the patient has deliberately or

accidently removed the needle.

6) When the tubing has been disconnected

and is saturating the bed while the

patient is bleeding freely from the

connector.

7) When the patient complains of pain or

the needle is inserted.

8) When you notice a lumpy, raised or

4111

HOSPITEDURSE AIDE

4111

Unit 2:


Page 18




OBJECTIVE

CONTENT

METHOD

2.6.7 Discuss nurse aides role in

tube feedings

inflamed area on the patient's skin

near th, place where the needle is

inserted.

J. Tube Feedings

1. Purpose - nasogastric

a. For patients who cannot eat normally

Lecture/Discussion

b. Consists of specialized formulas that

can be given through a tube

c. May be given by pump or gravity

d. Feedings always done by licensed nurse

2. Nurse Aide Role

a. Report to nurse if not dripping - if by

gravity

b. Report to nurse if patient begins to gag

or vomit

c. Never pull on tube when moving patient

d. Remember to fasten connecting tube to

patient's gown if not in use

3. Other tubes used for nourishment

a. Gastrogavage - location/purpose

b. Jejunostomy Tube

location/purpose

c. Nurse Aides role

HOSPITAL NURSE AIDE

Unit 3:

Caring for Patients on Special Units

Overview: This unit describes the nursing care adaptations required to care for patients with special problems or

assigned to a special unit.

Approx. teaching time 4 hours

OBJECTIVE

CONTENT

METHOD

3.0 Care for patients on special

units.

3.1 Provide basic pre-operative

and post-operative care.

3.1.1 Discuss general reasons a

person may be having surgery

and persons who assist.

3.1.2 Recognize six situations

which might upset a pre-

operative patient.

3.1.3 Describe the five things

that should be done

before surgery

I. Pre/Post-operative care

A. Terms

1. Pre-operative - before an operation or

surgery

2. Post-operative - after surgery

B. Introduction to surgery

1. Reasons to have surgery

a. Exploratory

b. Cure diseases

c. Slow down progress of diseases

d. Elective

2. Special medical personnel connected with

surgery.

a. Surgeon

b. Anesthesiologist

c. Scrubbing and circulation

.Recovery room personnel

C. Situations

1. Concern for family

2. Being away from work

3. Time away from work

4. A possible disability because of the

operation

5. The possibility of death or serious

complications

6. Fear of the unknown

D. Pre-OP checklist

1. Prior to surgery -

a. Identify patient by checking identifi-

cation band

b. Skin prep done and checked

c. Food restrictions, if any

411

Lecture/discu.,sion

Lecture/discussion

410

HOSPITIRURSE

AIDE

1110

Unit 3:


Page 2



OBJECTIVE

CONTENT

METHOD

3.1.4 Describe checks that should

be made just prior to going

to O.R.

3.1.5 Describe a prep and explain

what it is.

3.1.6 Define terms related to

surgery.

d. Nothing by mouth after midnight sign on

patient's bed.

(NPO) Nils per os - sign

at head or foot of bed

e. Enema given, if ordered

2. Prior to O.R.

a. Bath and oral hygiene

b. False teeth and removable bridges

removed

c. Jewelry and pierced earrings removed

d. Hair piece, wig, hairpins removed

e. Lipstick, make-up and false eyelashes

removed

f. Sanitary belt removed

g. Nail polish removed

h. Eyeglasses and contact lenses removed

i. Prosthesis (artificial hearing aid, eye,

leg, arm and so forth) removed

j. All clothing removed except clean

hospital gown

k. Patient allergic or sensitive to drugs

1. Urinary drainage bag emptied

m. Siderails in up position

n. Vital signs taken and recorded

o. Height and weight recorded

p. Time patient leaves for OR

q. Any pertinent observations about the

patient

E. Prep -

to make the skin as free from hair

Lecture/discussion

and as clean as possible

F. Anesthesia

1. Special medication that causes loss of

feeling in all or part of the body

Lecture/discussion

.

Example of OR checklist

Examples of different

vu

HOSPITAL NURSE AIDE

Unit 3:


Page 3



OBJECTIVE

CONTENT

METHOD

3.1.7 Discuss three types of

2. Types

anesthesia and effects on

a. General anesthesia - causes a loss of

patients.

sensation in the whole body

b. Local anesthesia - causes numbness or

loss of feelings in only part of the

body

c. Spinal anesthetic - causes loss of

feeling in a large area of the body,

usually from the umbilicus down to

and including the legs and feet

d. Epidural

3.1.8 Differentiate between anesthe-

3. Anesthesiologist - the doctor who

Lecture/discussion

tist and anesthesiologist.

administers the anesthetic to the patient

in the operating room

4. Anesthetist - the registered nurse who

administers the anesthetic to the patient

in the operating room

3.1.9 Describe symptoms if

G. Symptoms

Lecture/discussion

observed post-operatively

1. Choking

should be reported immediately.

2. Pulse

a. Fast (above 100)

b. Slow (below 60)

c. Irregular pulse beat

3. Respirations:

rapid (above 30), labored

4. Skin, lips, fingernails:

very pale or

turning blue (cyanosis)

5. Thirst:

Patient asks for water often

6. Unusual or extreme restlessness

7. Moaning or complaining of pain

8. Sudden bright red bleeding

3.1.10 Discuss causes and nursing

H. Vomiting

Lecture/discussion

care for a patient who is

1. Turn the patient's head to one side to

vomiting post-operatively.

prevent vomitus from being drawn back into

the lungs (aspiration)

2. Wipe off the patient's mouth and chin

r- t)a

4111

fiU

Unit 3:


Page 4

Overview: This unit describes the nursing care


HOSPIIIIIURSEAIDE

adaptations required to care for patients with special problems or

OBJECTIVE

CONTENT

METHOD

3. If the patient is conscious, rinse out

mouth with cold water.

Caution:

patient

is not to swal]ow water

3.1.11 Explain why careful conver-

I. Conversation

sation should be used around

1. A patient may appear to be unconscious,

a post-operative patient.

but not really be...

He/she may be able

to hear you

2. Say only those things you would want the

patient to hear if he/she were fully

conscious

3.1.12 Explain what should be done

J. Voiding

with the patient's first

1. Check first voiding after surgery for:

voiding post-operatively.

a. Odor and color

b. Amount

c. Record on output side of I & 0 sheet

2. If a urinary catheter is present, be sure

it is unclamped and draining.

Observe

color and amount

3. If outpatient must void prior to

discharge

3.1.13 Describe what to do for a

K. Returning from surgery

patient returning from

1. Help to move patient from the stretcher

surgery.

to the bed

2. Be sure the patient is covered with

blankets to keep him/her warm

3. Be sure the bedside rails are raised after

the patient is in bed

3.1.14 Discuss complications of

L. Complications

surgery.

1. Chest

61

Lecture/discussion

Lecture /discussion

Lecture/discussion

Lecture/discussion

a. The anesthetic may irritate the

patient's respiratory passages (mouth,

nose, trachea, lungs) and cause the

secretions in these passages to increase.

This might raise the chance of an infec-

HOSPITAL NURSE AIDE

Unit 3:


Page 5



OBJECTIVE

CONTENT

3.1.15 Explain the purpose of deep

breathing exercises.

3.1.16 Describe the procedure for

deep breathing exercises.

G

METHOD

tion in the lungs or other parts of the

respiratory system.

b. Smoking tends to irritate the whole

respiratory system.

Smoking may increase

the secretion of mucus, which also could

raise the chance of an infection.

c. After surgery many patients are so sore

they can't breathe deeply.

They can't

cough up the increased amount of mucus

material being secreted in the lungs.

This could cause a respiratory infection,

such as pneumonia.

d. A patient might vomit while he/she is

still unconscious after surgery.

The

vomitus might be aspirated, that is drawn

back into the lungs.

This could very

quickly cause an infection or even the

patient's death.

Saliva might also be

drawn into the throat and block the air

passages, which could cause an infection.

e. Unconsciousness and inactivity during

anesthesia allow mucus to accumulate in

the patient's respiratory passages.

2. Deep breathing exercises

a. Expand the lungs by increasing lung

movement and assist in bringing up lung

secretions

b. Will help prevent post-operative

pneumonia

3. Procedure for deep breathing

a. Assemble your equipment

1) Pillow

2) Specimen container, if a specimen

is ordered

3) Tissue

G

Lecture/discussion

Demonstration


Role play

Procedure checklist

Equipment needed:

Pillow

HOSPIllippURSE AIDE

Unit 3:


Page 6



OBJECTIVE,

CONTENT

METHOD

G5

b. Report to the medication nurse that

you are ready to start deep breathing

exercises.

If he/she wishes to give

the patient medications to relieve the

patient of any discomfort or pain, he/

she will do so at this time.

c. Wash your hands.

d. Identify the patient by checking the

identification bracelet.

e. Ask visitors to step out of the room.

f. Tell the patient that you are going to

help him/her with deep breathing

exercises.

g. Pull the curtains around the bed for

privacy.

h. Offer the patient a bedpan or urinal.

i. Dangle the patient, if allowed.

If not,

place the patient is as much of a

sitting position as possible.

j. Place the pillow on the patient's abdomen

for support.

k. Ask him/her to deep breathe ten times.

1. Count the respirations out loud to the

patient as he/she inhales and exhales.

If the patient can't breathe deeply, ask

him/her to cough.

Coughing is just

another way of breathing deeply.

m. Ask the patient to feel his/her chest as

they breathe to encourage deeper breathing.

n. Tell the patient to cough up all loose

secretions into the tissues, if a specimen

if not necessary or into a specimen

container if a specimen is needed.

o. Return the patient to a comfortable and

safe position in bed.

Specimen container

Tissues

Emesis basin

Grr(;

HOSPITAL NURSE AIDE

Unit 3:


Page 7



OBJECTIVE

CONTENT

METHOD

3.1.17 Describe purposes for

M.

turning the patient post-

operatively.

3.1.18 Describe materials/equip-

N.

ment used post-op

3.1.19 Explain by giving three

reasons why supports are used

post-op.

p. If a specimen has been collected, label

it and attacha laboratory requisition

slip

q. Dispose of the tissues

r. Replace the pillows under the patient's

head

s. Wash your hands

t. Report to your nurse manager or team

leader

1) That you helped with the deep breathing

exercises

2) Time during which you helped him/her

3) Number of exercises

4) Your observations of anything unusual

Turning the patient

Lecture/discussion

1. How often - every two hours unless you are

instructed not to

2. Purpose

a. Help him/her rest better

b. Protect the skin

c. Promote healing

d. Helps prevent pneumonia

Binders and elastic bandages

Lecture/discussion

1. Definition

2. Purposes

a. Give support to a weakened body part

b. Hold dressings and bandage in place

c. Put pressure on parts of the body to

make the patient more comfortable

d. Unless the binder is put on properly,

it can be more uncomfortable for the

patient then if it had not been used

at all

0 U

Lecture/discussion

Unit 3:


Page 8

Overview: This unit describes the nursing care


HOSPIII,NURSE AIDE

adaptations required to care for patients with special problems or

OBJECTIVE

CONTENT

METHOD

3.1.20 List three rules to follow

when patient has a binder.

3.1.21 Explain five reasons for

elastic stockings and ace

bandages.

3.1.22 List two types of anti-emboli

stockings

0.

3.1,23 Describe the nurse aides role

P.

in caring for patient with

apparatus for removal of fluids

3. Rules to follow

a. Keep the binder smooth and clean

b. Watch for reddened area

c. Use correct type of binder

Elastic stockings and ace bandages

1. Purpose

a. Applied to body extremities (arms,

hands, legs and feet)

b. Used either as treatment for thrombo-

phlebitis (blood clots of the leg) or

as a prevention against that condition

c. Compresses veins and therefore improves

the return of venous blood to the heart

d. Improve circulation

e.-In cases of sprain or strain at the

joint, they are used to provide support

and comfort

2. Types of Anti-emboli stockings

1) Knee-length

2) Full-length

3) P.A.S.

Gastric Suction

1. Purpose - removal fluids

2. Method - gravity or suction

3. Types

a. T-Tubes

b. Low-Intermittent

c. Hemovac

d. Chest tubes

e. Airway suction

f. Jackson-Pratt

4. Nurse Aide role -Observation

a. Report any leakage

b. Never empty collecting containers

without direction from nurse

Lecture/discussion

Lecture/discussion

Lecture/discussion

Lecture/discussion

HOSPITAL NURSE AIDE

Unit 3:


Page 9



OBJECTIVE

CONTENT

METHOD

c. Never raise the collection bottle

d. Never disconnect tubing

e. Never remove clamp kept at bedside

f. Observe fluid in container - if stops

increasing report to nurse

g. If asked to empty container -observe

for color, texture, and measure amt.

Record on intake-output sheet

h. Report to nurse if there is a change

in color/amt. etc of drainage

3.2 Recognize how care may change

II. Adapt Patient Care to meet developmental needs

Lecture/Discussion

because of patient's age and

A. Review Developmental tasks

condition

3.2.1 Adapt patient care for the

pediatrics patient.

1. Needs of persons in various stages

2. Communications and interpersonal relations

B. Caring for obstetrical patient

1. Definition

2. Departments within obstetrics

a. Labor and delivery

b. Newborn nursery

c. Post partum

3. Types of deliveries

a. Normal

b. Cesarean

c. Forceps

4. Infection control in O.B. units

a. Reasons

b. How hospital control

B. The pediatric patient

1. Communication

2. Importance of family to patient

3. Classifications of pediatrics

a. Newborn

b. Infants

c. Toddlers

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Unit 3:


Page 10

Overview: This unit describes the nursing care adaptations required to care for patients with special problemsor


OBJECTIVE

CONTENT

METHOD

d. Preschool

e. School-age

f. Teenagers

4. Special precautions in pediatrics

a. Fluid intake

b. Diet differences

c. Added safety precautions

1) Side rails - Bubble tops

2) Toys

3) Croupette - Cool mist tent

d. Adaptive equipment for child's needs

e. Helping child deal with feelings regarding

hospitalization

1) Fear - separation - loneliness

2) Pain

3) Irritability

f. Activity - play needs

HOSPITAL NURSE AIDE

Unit 4:

Emergency Situations and CPR.

Overview: The nurse aide will provide basic emergency care.

Approx. teaching time 8-10 hours

OBJECTIVE

CONTENT

METHOD

4.0 Recognize emergency situations

and describe the nurse aide's

role in an emergency.

4.1 Discuss listed emergency

situations and describe appro-

priate first aid measures.

4.2 Identify signs of severe bleeding

and first aid treatment.

4.3 Identify first aid procedures

for ." person with a seizure.

I. Emergency situations

A. Introduction

1. Definition of an emergency

2. Principles of emergency care

a. Remain calm and quick in informing

other health team members (emergency

call signal may be used)

b. Never leave patient alone

c. Use only necessary first aid procedures

while waiting for help

d. Follow instructions of nurse or

physician calmly and quickly

B. Severe bleeding

1. Causes may be internal or external

2. Signs of severe bleeding

3. First aid for severe bleeding

4. Emergency control of bleeding

a. Direct pressure

b. Elevation of part

c. Pressure points

d. Get help

b. Application of cold water

c. Get help

C. Seizures

1. Description of a seizure

2. Emergency cara

a. Protect patient from injury

b. Position on side if possible

c. Stay with the patient and get help

Lecture/discussion

Demonstration

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,

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HOSPIllIONURSE AIDE

Unit 4:


Page 2


OBJECTIVE

CONTENT

METHOD

4.4 Describe first aid for the

person who faints.

4.5 Describe shock and procedure for

providing first aid in shock

situations.

4.6 Demonstrate proficiency in

emergency CPR by becoming Red

Cross or AHA certified.

4.7 Describe rescue breathing and

identify purposes.

D. Fainting

1. Description of fainting

2. Protect the person from falling and

injury

3. Help patient to lying position or with

head between knees

4. Check patient's pulse and respirations

5. Get help.

E. Shock

1. Causes of shock

2. Symptoms of shock

a. Pale, cool skin

b. Weak, rapid pulse

c. Low blood pressure

3. Preventing and giving first aid in shock

a. Patient should be lying down

b. Cover to keep from losing body heat

c. Get help

II. CPR

A. Introduction to CPR

1. Description of cardiac arrest

2. Causes Of cardiac arrest

3. Result of cardiac arrest

a. Clinical death

b. Biological death

4. Goals of emergency CPR

a. Prevent irreversible brain damage- -

must be initiated immediately

b. By applying pressure on heart from

outside the body, blood is circulated

c. By breathing air into lungs, the blood

continues to receive oxygen

B. Rescue breathing

1. First determine if patient isn't

breathing and if there is a pulse

2. Checking for pulse and breathing

Lecture/discussion

Approved first aid

instructor or

approved certified

basic life support

instructor who will

follow approved

curriculum

Lecture/discussion

First aid or BLS

procedure


; 3

HOSPITAL NURSE AIDE

Unit 4:


Page 3


OBJECTIVE

CONTENT

METHOD

4.8 Describe emergency cardiac

compression and identify

procedure.

F"'J

3. Positioning of patient

4. Opening airway

5. Procedure for rescue breathing

C. Cardiac compression

1. First determine need

2. Rescue breathing always done with it

3. Procedure

4. Precautions

S 0

demonstration

First aid or BLS procedure

for one man/two man rescue


demonstration

N

HOSPITAL NURSE AIDE

Badasch, S.A., & Chesebro, D.S. (1988). The Health Care Worker, 2nd ed.Brady.

Hegner & Caldwell. (1988). Assisting in Long Term Care. Delmar

Schneidman, R., et al (1989). Being a Nursing Assistant, 5th ed. Brady.

Sorrentino, S.A. (1987). Textbook for Nursing Assistant, 2nd ed. Mosby.

Witmer, D.M. (1990). Geriatric Nursing Assistant - Advanced Training. Brady

HOSPITAL NURSE AIDE

Skills Checklist #1Admitting a Patient

Equipment: Admission checklist, specimen bottle for urine, hospitalgown and robe, clothing list, valuables envelop, scalefor ht. and wt., admission packet, bedpan, basin emesisbasin, water pitcher, thermometer, other items requiredfor specialty area.

NamePassed Needs more practice

1. Assembled equipment

2. Fanfolded bed linens to foot of bed

3. Placed hospital gown at foot of bed

4. Placed supplies in bedside stand

5. Introduces self when patient arrives

6. Escorts patient to room - introduces to roommates if any

7. Provides privacy during admission procedure

8. Assists patient to change into pajamas or hospital gown

9. Weighs and measures patient - records wt. and ht.

10. Assists patient unpack - put toilet articles away etc.

11. Completes admission checklist

12. If patient is allowed get crinking water

13. Orients patient to surroundings

_14. Explains hospital policies/procedures

15. Put to bed and adjust bed

_16. Take checklist to nurse manager and report

Comments:

Instructor's Signature Date

2

HOSPITAL NURSE AIDE

Skills Checklist # 2Transferring a Patient

Equipment: Patient's possessions, wheelchair or stretcher if needed,

NamePassed Needs More Practice

1. Assemble equipment

2. Wash hands

3. Check with nurse to make sure patient knows they are beingtransferred - then explain to patient what you will be doing

4. Check to be sure new unit is ready for transfer

5. Identify patient by checking wrist band

6. If there are visitors ask them to wait outside

7. Collect patient's personnel belongings and move with patient

8. Transport patient with belongings to new unit - wheelchair -stretcher what ever is appropriate.

9. Introduce patient to new roommates if appropriate

10. Make patient comfortable

11. Help unpack patients possessions if needed

_12. Report to nurse manager that transfer is completed and anypertinent information

Comments:


0

HOSPITAL NURSE AIDE

Skills Checklist #3Discharging,a patient

Equipment: Wheelchair, discharge slip, cart if needed

NamePassed Did not Pass

1. Wash hands

2. Identify the patient by checking I.D.

3. Collect patient's belongings - help them pack

4. Be sure all valuables and medications are returned to patient

5. Assist patient in getting dressed

6. Make sure patient has written instructions from nurse manager:Doctor's ordersPrescriptionsFollow-up appointment

7. Bring wheelchair to patient's bedside. Help patient into

wheelchair.

8. Before wheeling patient off floor, get discharge slip

9. Take patient to discharge desk or cashier or business office

10. Wheel patient to exit where meeting transportation. Help

patient from wheelchair into vehicle

11. Return wheelchair and release form to floor

12. Report to nurse manager that patient has been discharged

Report the time, type of transportation used, and who

accompanied the patient. Also report any pertinent

observations

13. Wipe the wheelchair with antiseptic

14. Strip the linen from bed and put in dirty linen

_15. Wash hands

Comments:


(-3

HOSPITAL NURSE AIDE

Skills Checklist # 4Isolation Technique

Equipment: Mask, gown, gloves

NamePassed Needs More Practice

Mask Techniques

1. Wash hands

2. Remove clean mask from container

3. Hold firmly, avoid necessary handling. Do not touch part thewill cover face. Hold by strings only.

4. Place mask over nose and mouth. Tie top strings over earsfirst. Then tie lower strings

5. Be sure mask completely covers nose and mouth during totaltime.

6. Remove mask just prior to leaving room after removing gown,if gown required. Wash hands before removing mask.

7. Untie the bottom ties first to avoid contamination. Holdmask by string loops only, discard mask in the paper con-

8. Wash hands.

Isolation Gowns

Donning

9. With clean hands, roll long sleeves of uniform aboveelbow

10. Unfold gown so opening is at the back

11. Put arms in sleeves

12. Fit gown at neck making sure uniform covered. Reach aroundand tie neck band with shoelace tie

13. Grasp edges of gown and pull to back

14. Overlap edge of gown, roll gown edges together in back and tie.

c.5

Isolation Cont. Page 2

Taking off Gown

15. Untie waist tapes and loosen gown

16. Use a paper towel to turn on faucet throw towel in wastebas-ket

17. Wash hand and dry with paper towel - use towel to turn offfaucet

18. Open neck band of gown - place fingers under one cuff topull sleeve over hand.

19 Pull arm out of sleeve by grasping the opposite sleeve withyour gown covered hand.

20. Roll the gown in half with contaminated part inside

21. If washable put in dirty linen inside room if disposableput in trash inside patient's room.

22. Wash hands. Use a paper towel to leave room. Put papertowel in trash inside patient's room

Putting on Nonsterile Glove - May be put on inside or outside room

---23. Wash hands

_24. Remove from container/wrapper

25. Grasp the cuff of the left glove with right hand and pull gloveon (Powdered gloves go on easier)

26. Pick up right glove with left-gloved hand and put it onAdjust fingers of both gloves with gloved hands

Removing Gloves

27. With left hand pull right glove off with cuff - donot touchyour hand with contaminated glove - dispose of glove in desig-nated container

28. Place fingers of right hand inside cuff of left glove. Pullglove off hand. Discard in designated container

---29. Wash handsComments:


41k ,get-

HOSPITAL NURSE AIDE

Skills Checklist #4Assisting Patient with Deep Breathing Exercises

Equipment: Pillow, Container for sputum, Tissue

NamePassed did not Pas

1. Report to nurse you are about ready to do deep breathingexercises - nurse may need to give medication prior

2. Wash hands

3. Check identification of patient - explain what you willbe doing and how patient can assist

4. Provide privacy - if visitors ask to wait in hall

5. Offer bedpan prior to beginning procedure

6. If allowed sit patient on edge of bed - if not sit inas upright position as possible

7. Place pillow on patient's abdomen for support - havepatient hug pillow

8. Ask patient to take ten deep breaths - count respirationsout loud as patient inhales/exhales - if cannot breathedeeply ask patient to cough

9. Provide sputum cup or tissue for patient to cough upsecretions.

10. Return patient to comfortable position.

11. Wash hands and report to nurse manager

Comments:


e)7

jun 91 87p. iowa - eric · 2014-05-05 · 6. identifies the special needs of residents/patients...

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